Amplatz thrombectomy device: unexpected interaction with the Cragg endoprosthesis.
In a 74-year-old woman, a Dacron-covered Cragg endoprosthesis was implanted into the left superficial femoral artery after successful recanalization of a 6-cm-long occlusion. At 4.5 months after discharge the endoprosthesis was occluded. In order to perform a thrombectomy, an Amplatz thrombectomy device (ATD) was activated and advanced into the occluded graft. Suddenly, a mechanical failure of the ATD occurred. Extraction of the ATD was achieved only after repeated attempts at rotating motion and jerky pullback maneuvers. The most likely explanation is that one of the graft-struts had advanced into the tip of the ATD and resulted in a broken drive shaft. Recanalization was completed by performing percutaneous transluminal angioplasty and pharmacological thrombolysis with recombinant human-tissue plasminogen activator. In conclusion, users of the ATD have to be aware of interactions of the ATD with the struts of implanted stents or grafts during thrombectomy.
Schwarzenberg
H
H
Klinik für Radiologische Diagnostik, Christian-Albrechts-Universität zu Kiel, Arnold-Heller-Strasse 9, D-24105 Kiel, Germany.
Müller-Hülsbeck
S
S
Heller
M
M
D000368:Aged; D000792:Angiography; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D017131:Thrombectomy / Q000295:instrumentation*; D015912:Thrombolytic Therapy / Q000379:methods
D005343:Fibrinolytic Agents; D011093:Polyethylene Terephthalates